The Town of Goldmine - VBS Child Registration
Please fill out this form and click submit.
Child's Name
*
Date of Birth
*
t-shirt size
*
Please select one option.
xs
s
m
l
xl
Second Child (optional)
Date of Birth
t-shirt size
Please select one option.
xs
s
m
l
xl
Third Child (optional)
Date of Birth
t-shirt size
Please select one option.
xs
s
m
l
xl
Parent or Guardian
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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Will This Child Need A Ride On The Church Bus?
*
Please select one option.
Yes
No
Some Nights
Submit
Description
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